Red flags & when to go in person for Headache in Children

Audience: pediatric

Headaches are common in children and often can be managed safely with telemedicine. Many headaches are caused by mild issues like tension or dehydration and improve with simple care. However, some headaches may signal a more serious problem that requires in-person medical evaluation. This guide helps parents and caregivers understand when telemedicine is appropriate and when to seek urgent or routine in-person care. Recognizing red flags such as sudden severe headache, neurological symptoms, or changes in behavior is important. Telemedicine can help assess symptoms, provide advice, and guide next steps, but it cannot replace physical exams or emergency treatments when needed. Knowing the warning signs and preparing for your tele-visit can help ensure your child receives the right care at the right time.

Red flags — go in person / ER

• Sudden onset of a very severe headache unlike any before — seek emergency care immediately.
• Headache accompanied by fever, stiff neck, or difficulty breathing — go to an emergency department.
• Changes in consciousness, confusion, weakness, numbness, difficulty speaking, or seizures — seek urgent in-person evaluation.

What telemedicine can do

• Assessment of mild to moderate headaches without red flags.
• Providing advice on hydration, rest, and over-the-counter pain relief.
• Guidance on when to seek in-person care or emergency services.
• Follow-up for headache symptom monitoring and management.

What telemedicine cannot do

• Physical examination needed to assess neurological signs.
• Emergency treatment for severe or sudden neurological symptoms.
• Diagnostic imaging or laboratory tests requiring in-person visit.
• Management of headaches with signs of infection or trauma.

Common Causes of Headaches in Children

Most headaches in children are due to common causes such as dehydration, stress, lack of sleep, or minor infections like colds. These headaches often improve with rest, fluids, and over-the-counter pain relievers. Understanding typical headache patterns can help decide when to use telemedicine for initial advice.

When to Use Telemedicine for Your Child's Headache

Telemedicine can be a helpful first step for headaches that are mild to moderate, have occurred before, and are not accompanied by other concerning symptoms. A healthcare provider can ask questions, review symptoms, and recommend home care or further evaluation if needed.

Red Flags That Require In-Person Evaluation

Certain symptoms with headache may indicate a serious condition and need urgent in-person care. These include sudden, severe headache; headache with fever and stiff neck; weakness, numbness, or difficulty speaking; persistent vomiting; changes in consciousness or behavior; or headache after head injury. Immediate medical attention is important in these cases.

Preparing for a Telemedicine Visit

Before your tele-visit, gather information such as your child's headache history, symptom details, any recent injuries or illnesses, medications taken, and any other symptoms. Find a quiet place with good lighting and ensure your device is charged and connected to the internet. Having a trusted adult present can help during the visit.

What to Expect After a Telemedicine Visit

After the tele-visit, follow the healthcare provider's advice carefully. This may include home care instructions, medication guidance, or scheduling an in-person visit if symptoms worsen or do not improve. Keep track of your child's symptoms and seek emergency care if red flags develop.

How to prepare for your tele-visit

• Note the time headache started and how long it has lasted.
• Record any recent injuries, illnesses, or new medications.
• Observe and note any other symptoms such as fever, vomiting, or changes in behavior.
• Ensure a quiet, well-lit space for the telemedicine visit.
• Have a list of any medications your child is currently taking.
• Be ready to describe the headache’s location, intensity, and any triggers.

After your tele-visit

• Follow the healthcare provider’s instructions for home care and medication.
• Monitor your child’s symptoms closely for any worsening or new red flags.
• Schedule an in-person visit if advised or if symptoms persist beyond expected time frames.
• Seek emergency care immediately if any red flag symptoms develop after the tele-visit.
• Keep a symptom diary to share with healthcare providers during follow-up.

FAQs

Can telemedicine diagnose the cause of my child's headache?

Telemedicine can help assess symptoms and provide guidance, but it cannot replace a physical exam or diagnostic tests sometimes needed to determine the exact cause of a headache.

When should I take my child to the emergency room for a headache?

If your child has a sudden, severe headache, fever with stiff neck, confusion, weakness, difficulty speaking, seizures, or headache after a head injury, go to the emergency room immediately.

Are headaches common in children?

Yes, headaches are common in children and often related to mild causes like dehydration, stress, or infections. Most are not serious but should be monitored carefully.

What can I do at home to help my child’s headache?

Ensure your child drinks plenty of fluids, rests in a quiet and dark room, and uses age-appropriate pain relievers if recommended by a healthcare provider.

Can telemedicine help if my child’s headache is new or different?

Telemedicine can be a good first step to discuss new or changing headaches, but if your child shows any red flag symptoms, in-person evaluation is important.

Sources

1. Headaches in Children and Adolescents — American Academy of Pediatrics.
2. Headache in Children — MedlinePlus, U.S. National Library of Medicine.
3. Migraine and Other Headaches in Children — Centers for Disease Control and Prevention (CDC).
4. Headache - Symptoms and Causes — Mayo Clinic.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation and treatment. If your child has any emergency symptoms or you are concerned about their health, seek immediate medical care.